Fair Health – A Consumer Cost Lookup Tool
In 2009, an investigation by then-New York State Attorney General Andrew Cuomo uncovered conflicts of interest in one system that health insurers used to calculate reimbursement for patients who received care from providers outside their plan’s network. As a result of this investigation, FAIR Health – an independent, not-for-profit organization — was created to establish and maintain a new database that could be used to help insurers determine their reimbursement rates for out-of-network charges, and provide patients with a clear, unbiased explanation of the reimbursement process.
As part of the collective settlement the Attorney General’s office reached with the insurers, FAIR Health received millions of de-identified healthcare claims that many had used to help them determine their rates. This data continues to be analyzed and processed with the goal of increasing its completeness, accuracy, and neutrality, as it will form the basis of our licensed products. The data will also be the basis of educational products and tools for consumers made available on this website.
FH Consumer Cost Lookup is a free tool which will give you an honest estimate of how much healthcare providers charge for medical and dental services in your area. It will also tell you how much of that cost you can expect your insurer to cover if you have to go out-of-network for care. It is based on millions of claims we’ve collected nationwide.
In addition to the Lookup tool, they provided many other resources to help you make informed decisions about your care. For example, they offer a video that helps guide you through an explanation of benefits form and an educational series they have titled “FH Reimbursement 101” that breaks down health insurance’s complicated terms and rules. They also offer a useful glossary and guide to healthcare resources.
Go to fhconsumer.org for resources and information.
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